Rene S Bourdeau, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT21195 Issued in FL

Practice address

2401 University Pkwy Ste 103
Sarasota, FL 34243-2894

Phone

(941) 444-5970

Fax

(941) 444-5971

NPI assigned

Jul 3, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siesta Key Physical Therapy, LLC.Group PAC ID 0143409854, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

95.48 of 100Reported as individual

Quality

90.96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Siesta Key Physical Therapy, LLC.

  • Physical Therapist
  • Siesta Key, FL
  • NPI 1548570161
  Medicare reassignment Care Compare group NPD
• Club 50, LLC

  dba Fyzical

  • Physical Therapy Clinic/Center
  • Sarasota, FL
  • NPI 1386034825
  Medicare reassignment NPD
• Request Physical Therapy Inc

  • Physical Therapist
  • Bradenton, FL
  • NPI 1356440523
  Medicare reassignment NPD
• Sarasota Orthopedic Associates LLC

  dba 360 Orthopedics

  • Orthopaedic Surgery Physician
  • Nokomis, FL
  • NPI 1013976422
  Medicare reassignment NPD
• White Sands Physical Therapy and Aquatics, LLC

  • Physical Therapy Clinic/Center
  • Sarasota, FL
  • NPI 1518230119

  Physical Therapist

  Medicare reassignment NPD
• Sarasota Orthopedic Associates, LLC

  • Orthopaedic Surgery Physician
  • Lakewood Ranch, FL
  • NPI 1962766576
  NPD
• Venice Rehab, LLC

  dba FYZICAL Therapy and Balance Centers

  • Physical Therapy Clinic/Center
  • Venice, FL
  • NPI 1447251947

  Physical Therapist

  NPD
• Randall C Morgan Jr MD PA

  dba University Park Orthopedics

  • Orthopaedic Surgery Physician
  • Sarasota, FL
  • NPI 1740304880
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346448180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 S TAMIAMI TRL",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935016",
            "telephone_number": "941-408-0670",
            "fax_number": "941-408-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 UNIVERSITY PKWY STE 103",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432894",
            "telephone_number": "941-444-5970",
            "fax_number": "941-444-5971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2990 US 301 N",
            "address_purpose": "LOCATION",
            "city": "Ellenton",
            "state": "FL",
            "postal_code": "342222008",
            "country_code": "US",
            "telephone_number": "941-721-1854",
            "fax_number": "941-721-1859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5980 S Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342313930",
            "country_code": "US",
            "telephone_number": "941-894-6848",
            "fax_number": "941-263-7491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURDEAU",
        "first_name": "RENE",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Botticelli, PH.D.
• Randi Botwinick
• Marvin D Bouchon, RPH
• Miroslava Plamenova Bounardjieva, DMD
• Ashley Bourcier
• Brandon Esteban Bourgeois, PA-C
• Julia Marie Bourguignon, DO
• Spencer Blake Bouton, PA-C
• Steven Bovio, OD
• Craig Matthew Bow, D.C.

• Physical Therapist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.